Features and outcomes of hypertrophic cardiomyopathy complicated by cardiogenic shock: an analysis of the FRENSHOCK multicenter prospective registry.

IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Aurore Ughetto, Miloud Cherbi, Nicolas Lamblin, Laurent Bonello, Guillaume Leurent, Bruno Levy, Meyer Elbaz, Stéphane Manzo-Silberman, Pascal Lim, Francis Schneider, Alain Cariou, Hadi Khachab, Jeremy Bourenne, Marie-France Seronde, Brahim Harbaoui, Gerald Vanzetto, Charlotte Quentin, Hamid Merdji, Nicolas Combaret, Benjamin Marchandot, Benoit Lattuca, Patrick Henry, Edouard Gerbaud, Danka Tomasevic, Etienne Puymirat, François Roubille, Clément Delmas
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引用次数: 0

Abstract

Objective: Cardiogenic shock (CS) in patients with left ventricular hypertrophy (LVH) due to hypertrophic cardiomyopathy (HCM) or hypertensive heart disease, is underreported in the literature. This study aimed to delineate the characteristics, management strategies, and outcomes of patients experiencing CS with preexisting LVH and HCM.

Methods: FRENSHOCK is a prospective multicenter registry including 772 unselected CS patients from 49 centers. Baseline characteristics, management, and 1-year outcomes were analyzed according to the occurrence on preexisting LVH.

Results: Among the 772 included patients with CS, CS occurred in 34 patients with preexisting LVH (4.4%, 1.4% with HCM). Clinical characteristics, medical history, usual medications, and hemodynamic parameters upon inclusion did not differ between the patients with or without LVH. Left ventricular ejection fraction in patients with CS and LVH was 27.3 ± 14.5% indicating a non-obstructive cause of CS. In-hospital management according to the LVH and non-LVH groups indicated no differences between the groups. The 1-month and 1-year mortality did not differ between patients with CS with and without LVH (26.5% vs. 26%, adjusted HR [hazard ratio] [95% CI]: 0.87 [0.44-1.72]) and 55.9% vs. 44.7%, respectively (adjusted HR [95% CI]:0.88 [0.54-1.42]). Subgroup analyses comparing HCM (n = 11) and hypertensive LVH (n = 23) revealed similar clinical characteristics, in-hospital management, and one-year rehospitalization rates in these patients.

Conclusion: In a large and unselected CS population, the prevalence of patients with LVH was low (4.4%) with less than half having HCM (1.4%). The presentation, management, and outcomes of CS were similar to the broader CS population in our series. However, HCM-CS represents a distinct clinical entity necessitating tailored management approaches.

肥厚性心肌病合并心源性休克的特征和结局:FRENSHOCK多中心前瞻性登记分析
背景:由肥厚性心肌病(HCM)或高血压性心脏病引起的左心室肥厚(LVH)患者的心源性休克(CS)在文献中被低估。本研究旨在描述既往存在LVH和HCM的CS患者的特征、管理策略和结果。方法:FRENSHOCK是一项前瞻性多中心注册研究,包括来自49个中心的772名未选择的CS患者。根据既往LVH的发生情况分析基线特征、管理和1年预后。结果:在纳入的772例CS患者中,34例CS发生于先前存在的LVH(4.4%, 1.4%合并HCM)。临床特征、病史、常用药物以及纳入时的血流动力学参数在有或没有LVH的患者之间没有差异。伴有LVH的CS患者LVEF为27.3±14.5%,提示非梗阻性CS病因。根据LVH组和非LVH组的住院管理显示组间无差异。伴有和不伴有LVH的CS患者的1个月和1年死亡率无差异(分别为26.5% vs 26%,校正HR [95% CI]: 0.87[0.44-1.72])和55.9% vs 44.7%(校正HR [95% CI]:0.88[0.54-1.42])。比较HCM (n= 11)和高血压LVH (n=23)的亚组分析显示,这些患者的临床特征、住院治疗和一年再住院率相似。结论:在大量未选择的CS人群中,LVH患者的患病率较低(4.4%),不到一半的患者患有HCM(1.4%)。CS的表现、管理和结果与本系列中更广泛的CS人群相似。然而,HCM-CS代表了一种独特的临床实体,需要量身定制的管理方法。
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来源期刊
Hellenic Journal of Cardiology
Hellenic Journal of Cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
4.90
自引率
7.30%
发文量
86
审稿时长
56 days
期刊介绍: The Hellenic Journal of Cardiology (International Edition, ISSN 1109-9666) is the official journal of the Hellenic Society of Cardiology and aims to publish high-quality articles on all aspects of cardiovascular medicine. A primary goal is to publish in each issue a number of original articles related to clinical and basic research. Many of these will be accompanied by invited editorial comments. Hot topics, such as molecular cardiology, and innovative cardiac imaging and electrophysiological mapping techniques, will appear frequently in the journal in the form of invited expert articles or special reports. The Editorial Committee also attaches great importance to subjects related to continuing medical education, the implementation of guidelines and cost effectiveness in cardiology.
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